Treatment started for a client in 2005. The company agreed to provide services as long as all payments were were made directly to the provider and the fee schedule was adhered to. The client was not to be charged any co-insurances or co-payments for private duty nursing.
As soon as the case began, payments were sent to the client instead of the provider, co-insurances were charged. Complaints were made to Horizon BCBS requesting again all payments be sent directly to the provider; however, that is still not happening.
Formal complaints with the insurance commissioner have also been filed, but Horizon is so incompetent, they can't even resolve anything past 10/31. The provider is awaiting over over $88,000 in back owed money.
Thankfully, the provider is being patient and not billing the client directly. When will Horizon BCBS get it together?
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